Printed on: February 19, 2014

Move to kill CAT Fund finished


BOISE -- A measure to eliminate Idaho's Catastrophic Health Care Fund failed to move beyond the Senate Health and Welfare Committee on Tuesday.

Sen. Steven Thayn, R-Emmett, said his bill would shift the funding in place for indigent services for Idaho's poorest and uninsured residents -- paid for by counties -- to the 45 community health care service locations around the

state. Community health centers, as stipulated by state code, are nonprofit groups that offer primary medical services and referrals for dental and mental health, as well as services for those who are uninsured or qualify for Medicaid.

After several questions from committee members about the viability of the proposal and lack of research on the topic, Thayn said the proposal was a way to brainstorm new ideas as alternatives to Medicaid expansion.

"(The clinics) are already playing an important role in the health care delivery system in the state of Idaho," he said.

Through the catastrophic fund, counties have historically been on the hook financially for people who need medical treatment but can't afford to pay for it. All 44 Idaho counties charge an annual levy to cover resident indigent health costs.

Tom Fronk, executive director of the Idaho Primary Care Association, said there is not enough capacity under Idaho's community health centers system to cover those who are seeking services through indigent funding. Many of the centers are not equipped to handle services that would require some medical care, including surgeries or emergency services.

"We are not emergency rooms," Fronk said. "We are not hospitals."

Other measures reforming the catastrophic fund are expected from Bonneville County legislators in the coming days. Reps. Janet Trujillo, R-Idaho Falls, and Thomas Loertscher, R-Iona, are expected to propose legislation addressing indigent care.

Rep. John Rusche, D-Lewiston, proposed legislation Feb. 5 to expand Medicaid, but that measure failed to gather enough consensus to allow for a public hearing. The expansion largely would have eliminated the need for the catastrophic fund.

CAT Fund Chairman Roger Christensen, who also serves as a Bonneville County commissioner, said he is encouraged legislators are talking about reform. Christensen reported to the Legislature's Joint Finance-Appropriations Committee in January that the annual health care costs for the state's indigent residents have doubled since 2002 -- to nearly $53 million per year.

"We have no position on any of these (bills), but we're very pleased that there's discussion going on," he said.

Some committee members said although Thayn's bill was not ready for "prime time," they were pleased to see other alternatives to Medicaid expansion come forward.

"There is a pony in this pile of stuff, we've just got to dig it out," said Sen. Marv Hagedorn, R-Meridian.